What is sciatica?
Sciatica is a condition that originates in the lower back and causes pain that radiates down the sciatic nerve through the hip, buttocks and the legs. Sciatica typically only affects one side of the body.
Most cases of sciatica can be treated with nonsurgical procedures, but patients who have significant pain, bowel dysfunction or leg weaknesses might be candidates for surgery.
Causes of sciatica
Sciatica is caused when the sciatic nerve becomes pinched. This can occur from the following conditions:
- Lumbar herniated disc — sciatica is the most common symptom of a lumbar herniated disc.
- Bone overgrowth or spurs — can put pressure on the sciatic nerve.
- Tumors — the sciatic nerve may be compressed by a tumor.
- Lumbar spinal stenosis — as the spinal canal narrows, this puts pressure on the sciatic nerve.
- Piriformis syndrome — as the piriformis muscles run down the buttocks into the leg, the sciatic nerve can get irritated and pinch the nerve.
Risk factors for sciatica
As you get older, you are more prone to get herniated discs, bone spurs and other spine conditions that could irritate the sciatic nerve and cause sciatica.
Other risk factors for sciatica include:
- Obesity — excess weight can increase stress on the spine and cause sciatica.
- Occupation — jobs that require sitting for long periods or carrying heavy loads can contribute to sciatica.
- Extended periods of sitting — people who sit for long periods of time or are sedentary are more likely to develop sciatica.
Symptoms of sciatica
The most common symptom of sciatica is pain that radiates down the lumbar spine (lower back) to your buttocks and down the back of your leg. Pain can pop up at any point along the pathway from the lower back to the calf and can vary from mild to severe pain.
- Pain can worsen when you sneeze or cough
- Extended sitting can also aggravate the symptoms
- Numbness, tingling or muscle weakness in the affected leg or foot
- Sharp pain that is so intense that walking is difficult
Diagnosis of sciatica
If you suspect you have sciatica, call your spine specialist to schedule an appointment. Your physician will do a physical exam to test your range of motion, feel your spine, look for muscle spasms, test reflexes, muscle strength or nerve changes. Your doctor will get a medical history by asking what your symptoms are, determine what caused the initial symptoms and when the symptoms are worse.
The doctor may also order diagnostic testing to determine the cause of the sciatica, including:
- X-ray — can help determine if there is a bone growth that is pressing on the sciatic nerve.
- MRI — can determine if you have a herniated disk.
- CT scan — can show more details of what is happening in the spinal cord and spinal nerves.
- Electromyography (EMG) — tests the impulses in the muscles and can confirm if a nerve is compressed caused by spinal stenosis or a herniated disc.
Together, this information will help your doctor diagnose your sciatica and develop a treatment plan specially created for you.
Treatments for sciatica
Previously, physicians recommended rest to treat sciatica. Newer research indicates that activity can speed recovery. Additional treatments may include:
- Steroid injection — may help reduce pain by reducing inflammation around the sciatic nerve.
- Physical therapy and rehabilitation — a combination of stretching, aerobic condition and strengthening exercises can help you recover more quickly from sciatica pain.
- Surgical decompression — removal of the bone spur or herniated disc that is pinching the sciatic nerve; surgery is typically recommended when sciatica causes loss of bowel control or progressively worsens with therapy.
Recovery from sciatica
If you follow your physician’s or physical therapist’s instructions, most people will recover from sciatica without surgery. Your physician will also recommend lifestyle changes that can help relieve unnecessary stress to the spine.
To prevent future cases of sciatica, it is important to exercise regularly, maintain proper posture when sitting and use good body mechanics.